A small but growing body of men in Lesotho are successfully challenging traditional gender roles and becoming professional midwives.
At the Mpharane Health Centre in Mohale’s Hoek district, Ntlhane Sehloho is busy examining his next patient.
Sehloho is one of about 300 male midwives in Lesotho and has been doing the work for two decades.
The exact number of male midwives is not available, as the government does not keep the data according to gender.
Talkative and ready with a joke, he seeks to put women at ease from the first of their prenatal visits.
Sehloho had good grades in school and wanted to become a nurse to help address the difficulties he had witnessed firsthand growing up in his rural community.
"So as I was growing, our village is far away from the health facility, so most women who are pregnant, some were delivering at home, so it was just a mess.," he says. "So, I then said that I’m going to grow and I’m going to be a nurse.”
Health authorities later encouraged him and other male nurses to train as midwives to help address deaths around childbirth in a country with poorly staffed rural health posts and a population of just over 2 million people.
Now, after efforts to bring care closer to rural communities, UNICEF data show that 92 percent of births in Lesotho are now attended by a trained health care provider.
Sehloho is dedicated to his profession; he spends three hours travelling on mountainous roads to reach the clinic and the women he serves.
He believes that male midwives are a necessity and are becoming accepted.
"There are quite a lot, and if you can go around the country, in most of our health centres, the ones in charge are those male midwives and even in a class, you will find that we have twenty student nurses or student midwives and ten males. So that says for Lesotho it’s normal to be a midwife,” says Sehloho.
It's clear his profession gives him pride and satisfaction.
"When I look back and say, this child? I know I was the one delivering them. When I see those twins that I met at the maternity hospital? I know they are my child. I’m so happy, I’m looking back with a happy smile," he says.
According to the United Nations, for every 100,000 live births, about 530 women die - that's far above the global average of about 200.
The government emphasises that gender shouldn’t matter in childbirth care.
While some women prefer female midwives, others appreciate the attentive care that male midwives provide.
World Health Organization figures estimate that men make up less than 1% of all midwives around the world. Organizations like the WHO and UNICEF have called for more people, male and female, to become midwives and address shortages in childbirth responders.
Blandina Motaung the Sexual and Reproductive Health and Rights Coordinator for UNFPA says in many cases men will show more care and caution than female midwives because they aren't as familiar with the process of pregnancy and birth.
"For female midwives, the majority of them would have gone or will go through the process of pregnancy and childbirth, but for the men, because they have not gone through the process, they become more vigilant and more attentive to the nitty gritty, and that is its own improved quality of care that they provide," she says.
Expectant mother Mpolokeng Mafereka admits she feels less comfortable being under the supervision of a male midwife.
"I am more comfortable being treated by a female person. I feel more comfortable with a woman because men are not usually people who work in the space of pregnancy," she says.
Sehloho acknowledges that it is a matter of gaining women’s trust. He tries to put them at ease by explaining how he has delivered babies for years and how he grew up in similar rural circumstances.
21-year-old Bonolo Tebello says she has never had a problem being treated by a male midwife.
“I’m happy to be treated by a male because they still provide the same level of care,” she says.
